Nationwide, Americans’ well-being improved in 2016 compared to 2015 and 2014. While many enjoy comfortable, healthy, and happy living and take their well-being for granted, not all Americans enjoy such standards. For many, hardship, pain, and despair can be a part of life as for them basic elements of well-being remain elusive.

The well-being of Americans varies dramatically, depending on where they live. To capture Americans’ general well-being, Gallup surveyed 177,281 people to build the Well-Being Index in partnership with health and wellness organization Healthways. The index measures whether individuals feel a sense of purpose, have supportive relationships, are financially secure, are satisfied with their community, and are in good physical health. According to the survey, Hawaii residents report the highest well-being, West Virginia’s the lowest.

Pennsylvania is the fourth largest coal producing state. While the industry has a substantial economic impact on the state and employs roughly 14,000 workers directly, the burning of coal has led to substantial environmental damage. The state’s air pollution is measured at 11 micrograms of coarse particulate matter per cubic meter on the average day, the most of any state other than California. In other measures of public health and safety, however, the state fares relatively well. Pennsylvania has nearly the best immunization coverage of any state, and one of the lowest property crime rates in the country.

People’s perception of their own well-being is often the product of a number of objective socioeconomic factors. 24/7 Wall St. matched Gallup’s ranking with data on health habits and outcomes, educational attainment, crime, and several other socioeconomic measures.

States where residents report high well-being tend to be quite affluent, while the opposite is true among states where residents report low well-being. The median annual household income exceeds the national median of $55,775 in 14 of the 25 higher-ranked states, while this is the case in just six of the 25 states on the low end. In an interview with 24/7 Wall St., Dan Witters, research director at the Gallup-Healthways Well-Being Index, explained that while “in wealthier communities in general you’re going to expect to see better well-being,” as Witters said, there are many exceptions to this relationship. Income can only affect well-being up to a point. Generally, income is directly correlated with financial well-being up to a threshold of about $75,000 a year. Beyond that, Witters added, “the richer you get the ever-greater amounts of wealth you need to tack on on top of it to continue to push life evaluation higher and higher.”

Witters further explained how difficult it can be for a state to change its position in the rankings. A few states, including Colorado, Hawaii, Montana, and Minnesota have been in the top 10 in all nine years of the Gallup survey. Other states, such as Mississippi, Kentucky, and West Virginia remain consistently on the low end of the ranking.

However, while income levels can make self-evaluations more entrenched, working to improve certain aspects of communities can dramatically raise well-being, even in low-income areas. Karissa Price, president of Healthways, told 24/7 Wall St. that a Healthways initiative, known as the Blue Zones Project, invests in well-being and aims to improve longevity and quality of life, irrespective of income. Blue Zones identified certain behaviors and attitudes common in some of the world’s happiest and longest living populations, such as having a sense of purpose, eating right, and cultivating close relationships.

Texas and Florida had the some of the largest improvements in well-being in the history of the survey, a trend Price argued can be attributed to the introduction of Blue Zones interventions. “I don’t think it’s a coincidence that happen to be the places where we’ve seen the greatest interest in 2016 in expanding the Blue Zones work.”

Many of the factors that can contribute to better overall well-being can do so in multiple, interrelated ways. We considered college attainment rates, which bore a strong relationship with Gallup’s rank of overall well-being among states. Most of the states with low college attainment had among the worst overall well-being. A college education can contribute to well-being by increasing the chances of obtaining a good job and adequate income. A college education has also been shown to provide people with a sense of purpose and direction in life.

Obviously, having or not having a job can have a significant impact on personal happiness. The quality of life among employed populations still varies considerably, however, based on a variety of factors summarized within Gallup’s purpose category: having the right career for you, liking what you do each day, using your strengths, learning and growing, setting and reaching goals, and being inspired by a leader. Because of how varied work experiences can be, employment levels and a population’s reported sense of purpose in life are not in lockstep across states.

Residents of states with the highest life evaluations typically report similar behaviors and health outcomes. Obesity, smoking, and exercise, for example, are all far more common in low well-being states.